Understanding Behavior for Alzheimer’s Caregivers
George used to stand in a corridor for hours - counting. "One, two, three, seven, one, ten". He was a resident in a nursing home and when he was doing his counting he would refuse to eat and it was very difficult to get him to engage in any sort of activity. Then, one of the nurses talked to a relative. George had been a pig farmer and he regularly counted out the pigs going to slaughter. Knowing this staff could say to him, “George the pigs have gone. Come for lunch now. Have a break before we get back to work.” It worked well. It settled George and he was able to go for his meal or to the bathroom.
Understanding behavior and how it can change when someone has Alzheimer’s is important for our caregiving skills. Alzheimer’s is a neurodegenerative disease in which huge damage is caused as brain cells die. Memory, language, perception, how our brains interpret messages from our senses and motivations are all affected by Alzheimer’s.
People with Alzheimer’s, like all of us, have taken a very personal journey through life. Our past inevitably influences our current behavior. When someone has Alzheimer’s, memories of long ago are more easily retrieved. If we know about what was important to someone in the past, behaviors that may appear irrational or strange can be given meaning.
We only have to reflect on the complexity of our own feelings and lives to know that behavior is a complex expression of who we are. In Alzheimer’s caregivers have to interpret behaviors, as they can be an expression of their unmet needs.
Sometimes memories from the past cause great unhappiness and can be acted out in inappropriate ways. However I have been told by relatives that a close relative has become a much nicer and kind person once they have Alzheimer’s.
Physical changes and illnesses can affect behavior too, sometimes radically. Mazie’s sudden increased confusion and loss of continence was explained when a nurse noticed how hot her skin felt. Nursing staff took her temperature and it was high. The doctor diagnosed a urinary tract infection that was treated and Mazie improved quickly.
Don’t put off getting medical help if you believe a health issue is causing sudden behavior changes . Physicians can diagnose and treat many diseases that will improve mental states. They can make a referral to more specialized services if required.
Attributing a behavior to meanness or blame is rarely helpful. We must try to understand the person as an individual rather than just a disease process. Caregivers' best coping skills come from love, care and concern.